Coronavirus is swirling around the country, with states that reopened in May shutting down again, and some that battled outbreaks early on finding they have returned.
By contrast, Maine appears an island of safety, with the nation’s lowest count of new cases, and one of only two states showing declines.
One of the primary reasons is the work of Dr. Nirav Shah, director of the state Center for Disease Control and Prevention.
Ironically, another island is never far from Shah’s mind as he calmly reassures and informs Mainers amid, as he describes it, the “firestorm” of coronavirus.
Last week, in his first extended interview for print since the pandemic began, he said he thinks often about history, and the responsibilities he bears. “It weighs on my mind almost every day,” Shah said.
His thought experiment, as he called it, involves a long-lost civilization that has long puzzled archaeologists, and produced best-selling books by geographer Jared Diamond.
“What were the people on Easter Island who cut down the very last tree thinking?” Shah said, leading to “its own self-imposed catastrophe.” Were they saying, “Am I screwing this up, and if so, what are the warning signs? Were they saying ‘It’s fine,’ or ‘This is a really bad idea and we should tell the boss?’”
The Easter Islanders, he suggested, “might have called on God the way we call on science.”
Shah said he always tries to keep this in mind. “It’s what I ask myself every time I make a decision,” he said.
During the 40-minute conversation, Shah attributed Maine’s success in containing the spread of COVID-19 compared to other states more to voluntary citizen action, not state orders and restrictions.
“Public policy is important,” he said, “but what the public does is even more important.”
Early and aggressive testing helped, Shah said, since “we were able to eliminate the priority tiers most states had.” But he quickly returned to the actions of individuals.
The two major differences were that, early on, Mainers reduced travel dramatically, and followed 14-day quarantines. More recently, they have become adept at using masks.
“It’s not perfect, but when you look at those photos of people massed on the beaches in other states, we’re doing well,” Shah said.
It’s not that Maine is entirely out of the woods. Asked about the outbreaks in other states, Shah said “I’m very, very, very concerned. There’s a distinct risk we’ll get engulfed in the wave. … We shouldn’t become complacent.”
Shah straightforwardly addressed the vexed subject of who is protected through the use of face coverings, acknowledging that mask-wearing has become a political and cultural flashpoint.
“It’s true that masks primarily protect other people because the virus is expelled in droplets,” he said. “There is some emerging data that mask-wearers are somewhat protected, too.”
He added, “It’s a rare thing, that we’re asking people to do something not entirely for themselves.” And Mainers, he said, “are among the people who took it seriously.”
Part of a team
The question of whether we’re rebounding from the confusion that marked the pandemic’s early days is on everyone’s mind, including Rep. Patricia Hymanson, D-York, a physician and co-chair of the Legislature’s Health and Human Services Committee. It was Hymanson who, at a January legislative briefing, asked Shah what kept him up nights; he responded by talking about a virus reported in China.
Now, she said, “Every day takes us farther on a path. There hasn’t been a recovery, we’re just on a different part of the journey. But I’m really proud of Maine for staying on a healthy path that’s not apparent in many other states.”
For that, Hymanson credited the leadership of Dr. Shah, along with Gov. Janet Mills and Health and Human Services Commissioner Jeanne Lambrew.
“He’s more than a single person, he’s part of a highly organized team,” Hymanson said of Shah. But she also sees him as “remarkable in expressing gratitude, that all of us in our houses are doing the right thing.”
While admitting “you can’t prove what you’ve prevented,” Hymanson said she has little doubt that Shah has made a difference.
“He’s trustworthy, and having someone like him in the political sphere is remarkable,” she said. “When I think of Dr. Shah, I see how that trust has translated into genuine health for Maine people.”
Dr. Dora Anne Mills, who served as Maine CDC director under Govs. Angus King and John Baldacci, said Shah turned out to be the right person at the right time.
Dr. Mills, who is now chief health improvement officer for MaineHealth in Portland, was participating in a conference call of state health directors, which she does as an alumnus, in late 2018 when she mentioned that Maine was looking for a new CDC chief (“without saying I was the governor’s sister, or that I didn’t want the job myself”).
Before the end of the call, Shah responded by email that he was interested. At the time, he held the comparable post in Illinois, but the governor he served had just been defeated for re-election.
“We talked that night,” Mills said. “I found him to be highly intelligent, but with a warm and engaging personality.” Since then, she said, “I’ve gotten even more impressed. I didn’t know about his astounding and exemplary communication skills. He provides the perfect blend of data and science – and philosophy. In a distressing and challenging time, people need that.”
Shah’s arrival in Maine in May 2019 turned out to be auspicious, although not everyone would have seen it that way.
“That weekend, we got word that a large number of asylum seekers would be arriving in Portland,” he said.
The Portland Exposition Building was the arrival point, and provided temporary housing. Shah met Dr. Mills there, acting in her MaineHealth role. “We were just thrown together in the sandbox,” she said. “We were figuring out how to get vaccines and equipment, calling back and forth about linens.”
As public health professionals, “We had a great time working together,” Mills said, and the two have since become friends. “It’s a rare week when I don’t hear from him, usually on his way home, sometimes at 6 but now more often at 9 at night.”
Shah said he also values the Expo experience as his first chance to work directly with Gov. Mills, who arrived while he was there.
“My goal from day one was to rebuild Maine CDC into a higher level of prominence and respect,” he said. “I would probably not have had as direct a relationship (with the governor),” had they not, at the beginning, been together at the Expo.
“Unless you’ve already worked for another governor, you probably don’t know how to do it,” Shah said. “I already had operational experience most state directors didn’t have.” From early on, he said, “I knew what her concerns were, how she thought.”
He found out quickly, Shah said, that “she doesn’t like to be called ma’am.”
Asked for comment, Mills provided a statement, saying, “Like many Maine people, I am grateful for his counsel, his humanity in this difficult time, and his unwavering commitment to conveying critical and timely information to the people of our state. We are fortunate to have him at the helm of the dedicated and tireless team at the Maine CDC.”
Illinois controversy
It wasn’t necessarily bound to be a good start.
In Illinois, Shah’s department investigated and reported on a series of outbreaks of Legionnaires’ Disease at the Quincy Veterans Administration Home, the largest and oldest in the state, dating to 1886. Eventually, the entire plumbing system had to be replaced in the aging buildings, after other remedial measures failed to end the outbreaks.
The VA home director eventually resigned, and Shah came under sustained criticism, including calls for his resignation from Illinois U.S. Sens. Dick Durbin and Tammy Duckworth. They renewed their call on Election Day in 2018 when Shah’s boss, Republican Gov. Bruce Rauner, was defeated by Democrat Jay Pritzker.
Dora Mills said the Illinois situation was thoroughly vetted before Shah was hired in Maine. He followed all the rules, she said, and criticism that he should have reported earlier on the VA home investigation is unfounded.
“You have to follow the law, and he did,” she said. “If you reported on every investigation you ever opened, you’d fill the newspaper.”
Said Shah of Gov. Mills, “She decided to peel back the layers, and say, ‘Is this guy smart, did he do his job, and is he good at what he did.’”
The controversy followed Shah to Maine; he was among one of the few Mills appointees to receive scrutiny. Several Republican legislators said he shouldn’t have been hired.
After being criticized by Democratic officeholders in Illinois, and Republicans in Maine about the same events, Shah said, “The irony of that was not lost on me.”
He was comfortable serving with Rauner, whom he called “a moderate, even liberal, Republican. We used to joke at cabinet meetings that there were more Democrats in the room than Republicans.”
He said he has always considered himself “a firm moderate” in keeping with empiricist training at the University of Chicago, but after he arrived in Maine, he decided “I’m not a Republican,” and has since registered as a Democrat.
The value of credibility
Despite his confidence in science, and his matter-of-fact way of presenting it, Shah knows his success also requires other qualities.
When he goes before the camera – for about 90 daily media briefings so far, with no end in sight – he said, “The only thing I’ve got is my credibility. I can have all the answers in the world, but if people don’t believe you, it doesn’t matter. If people don’t trust you, the science doesn’t matter.”
This is why he’s so careful in answering questions. “If you lose your credibility, it’s gone forever,” Shah said. “I can’t think of a single public figure who regained trust after it’s been lost.”
He also knows how to inject “a bit of levity” into his briefings, coining nicknames for reporters and making unexpected digressions.
“Let’s face it, this is dark, depressing stuff. Every day, I deliver bad news,” Shah said. “We have to find ways to retain our humanity.”
He said he has two principles he also keeps in mind during the briefings.
The first: “If a reporter, or anyone, asks you what time it is, do not tell them how to build a clock.” The clock answer, for an expert, may in fact be easier to deliver, but it’s not going to get through to the audience, he said.
The second: “Do not shy away from the bad news. It’s there. People have died, people are suffering. Never sugar-coat the truth.”
While Shah has said numerous times “how gratified and honored I am by the welcome and acceptance” he’s received, he insisted “it’s far more telling of the character of Maine people than anything else.” He said he has found plenty of open-mindedness and tolerance in his adopted state.
State Rep. Hymanson sees the same qualities in the most recent briefings as she did at the beginning.
“He’s been consistent, with a big heart, and his embracing of Maine, and his gratitude,” she said. “He’s very smart, very engaged in the science in a way I understand, because I love science, too. And because he’s a strong leader, he’ll be with us over this entire journey.”
Douglas Rooks has covered Maine issues for 35 years as a reporter, editorial writer, columnist, and former editor of Maine Times.
Shah on the similarities of ‘things unseen:’ Hatred, coronavirus
Dr. Nirav Shah was invited by the Unitarian Universalist Society of Bangor to provide a reflection for the church’s annual remembrance of Charles Howard, the 23-year old gay man attacked and killed at the State Street bridge in 1984.
He did, in an 18-minute video, on Sunday, July 12.
Speaking from notes about “Things Unseen,” Shah – appearing without his familiar glasses – bound together the twin contagions of coronavirus and hatred.
“In some cases it’s a virus, in others it’s someone’s sexual orientation, and how our reactions to what we cannot see can be motivated by misunderstanding and fear, rather than by compassion and community. In this time of coronavirus, this tendency is all the more insidious …” he said. “Things like the virus are unnerving precisely because we cannot see them.”
Although he expects medicine to develop a coronavirus vaccine, “Sadly, there is no vaccine to temper the fear, xenophobia, and racism and their outbreaks.”
“Our society feels fragile” Shah said, probing deeper into collective responses: “When we feel helpless in the face of the invisible, the temptation to turn against the most vulnerable among us, to blame someone visible, something seen, can be very great, and that pernicious temptation can spread much more quickly than the virus itself.”
He pointed to names – “Wuhan flu, Spanish influenza” – that Americans gave viruses they thought originated far away, but not those in our midst: AIDS, first reported in New York, or MRSA, in Boston.
Marginalized people are easily scapegoated, he said. Cholera, spread in the 19th century by American shipping, was blamed on Irish immigrants. As recently as 2003, Canadians of Chinese descent, suspected of causing the SARS epidemic, “were thrown out of their homes and businesses. … In each case, people replaced what they couldn’t see, a virus, with what they could see: race.”
When Charlie Howard walked by the State Street bridge, his attackers “set out to extinguish what they could not see or understand … something they did not want to understand,” Shah said.
He added, “Just like COVID, misunderstanding, fear, intolerance, xenophobia and hate are all viruses, each more pathogenic than the last, and each is contagious.”
Just as “the opposite of poverty isn’t wealth, but dignity,” the answer for intolerance “is not just education, but community,” he said. “Those who are unseen are much easier to harm than those who are seen in their community.” He spoke of authoritarian regimes where even making eye contact with neighbors can be a form of resistance.
Shah asked those listening “to examine your daily lives for those who may be unseen. To see those in your lives, who were there all along,” because “faith, fundamentally, is the assurance of things hoped for, that same conviction of things not seen. … When this is all over, what will be remembered are not the case counts, the positivity rates, or the policy choices. What we will remember is how we treated one another.”
— Douglas Rooks
A peek behind the mask
For someone suddenly so prominent, there are few details in the public realm about Dr. Nirav Shah. His official biography at the Maine Center for Disease Control and Prevention is notably short of them – including his age, which is 43.
There’s certainly widespread curiosity. The Fans of Dr. Shah Facebook page has more than 31,000 members and nearly 3,000 daily posts. Bangor television show host Dan Cashman devoted a portion of an interview aired July 11 to probing Shah’s highly visible use of Diet Coke, a regular prop during his daily briefings.
It turns out that the doctor, with otherwise impeccable health habits, has one vice. He was finally convinced by a physician friend, an outdoorsman, that he should give up Diet Coke.
But, he said, “After a month I felt exactly the same” so he went back to it, reasoning that everyone needs comfort in times of stress.
So what else can we discover?
Shah was born and raised in Medford, Wisconsin, a small city in the north-central part of the state. When he first thought about coming to Maine, he saw some parallels – “cold weather and quite a few cultural similarities” – but found, at least in the southern part of the state, that “Wisconsin is a lot colder.”
He went to college mostly at the University of Chicago, earning both his law and medical degrees, and practicing “rigorous empiricism” in both fields. The “Chicago School” of law and economics is known for this approach, and he applied it in public health work during a lengthy stint in Cambodia.
Shah’s parents came from India, and later retired to Texas. His arrival to take up the Maine CDC job was delayed because his father, long ailing, was dying. His mother now lives with Shah and his wife in Cumberland County most of the year.
And yes, he has a dog – a golden retriever, Quincy, who’s now 11.
“At least we think he’s a golden,” Shah said. “We got him when he was 7 months old, from PetFinder.com.”
Quincy has since become a family member: “He’s with us every minute. We structure vacations around him.”
Shah is touched and moved by his reception in Maine. Though he’d heard about the “people from away” mantra, when the pandemic and briefings began, “I’d lived here for nine months, a brown-colored man with a funny name, yet I was welcomed and accepted.”
Dr. Dora Ann Mills, a past Maine CDC director, knew that early on. In the Maine dialect, “Shah” sounds exactly like “Shaw.” She told him, “They’re no longer misspelling your name.”
— Douglas Rooks
